Why are so many women told to “just live with” menopause symptoms? Christine Stewart, PT, CMPT, explains how fear of breast cancer shapes menopause care, what the research really says about hormones, and why PTs and OTs are the right people to start the conversation.
 
“We’re not gonna put you on estrogen, because that causes cancer.” That’s what Christine’s doctor told her when the night sweats, heart palpitations, and sleepless nights started during COVID. Her next physician wasn’t sure a hormone patch was even made in this country. It is. If she was going through this, she figured, so was everyone else. So she wrote a course to give providers the information she couldn’t find.
 
This episode is made for clinicians: PTs, OTs, and anyone who treats pelvic floor dysfunction. It’s for you if your patients ask about hormones and you don’t know what to say, or if you’ve never brought up menopause at all.
In Episode 2 of Explore the Floor, host Allison Ariail, PT, DPT, CLT-LANA, BCB-PMD, PRPC, talks with Christine Stewart, PT, CMPT, to mark Breast Cancer Awareness Month. We already ask patients about bowel, bladder, and sexual health, Christine says, so “let’s just add this to the list.” She points out that half of a woman’s life can be spent in menopause, and many providers still get little training on it.
In this episode:
 
How the Women’s Health Initiative created decades of fear about hormones and breast cancer
 
Absolute vs. relative risk, and why the headlines sound scarier than the real numbers
 
The earliest signs of perimenopause, and why “I’m only 42” doesn’t rule it out
 
How genitourinary syndrome of menopause hides behind leakage, urgency, and painful sex
 
What hormone therapy does well, and what it doesn’t do
 
Why “menopause is not eating your brain”
 
Sleep, stress, and the self-care conversation
 
Why strength training doesn’t mean lifting heavy: “You have to lift enough that the last two reps are hard.”
 
Want to learn more? Christine teaches Menopause Transitions and Pelvic Rehab with Herman & Wallace. https://hermanwallace.com/continuing-education-courses/menopause-transitions-and-pelvic-rehab-remote-course
 
You can read more about Christine and her work here: https://hermanwallace.com/faculty/christine-stewart
 
New to pelvic health? This guide walks through how to become a pelvic floor therapist, step by step: https://hermanwallace.com/how-to-become-a-pelvic-floor-therapist
 
This content is not a substitute for medical care. Views expressed are not necessarily those of Herman & Wallace.

Want to become a pediatric pelvic floor specialist? Dawn Sandalcidi, PT, has treated kids with constipation, bedwetting, and leaks for 30+ years. She shares how she got started, what to look for, and why PTs and OTs are built for this work.
 
"Children are not small adults." Dawn Sandalcidi learned that in 1993, when a urologist sent her an eight-year-old and said, "Get this kid out of my office." There were no pediatric pelvic health courses then. She built the field one patient at a time.
This episode is made for clinicians: PTs, OTs, and anyone who treats pelvic floor dysfunction. It's for you if you're wondering how to become a pelvic floor therapist, or if you treat adults and are curious about treating peds.
In Episode 1 of Explore the Floor, host Allison Ariail, PT, DPT, CLT-LANA, BCB-PMD, PRPC, talks with Dawn Sandalcidi, PT, RCMT, BCB-PMD. Her message to therapists is simple: "These kids, these families need you." Dawn says nearly a third of children deal with constipation. Many families never mention it, and many doctors never ask. Pelvic health therapists are often the first to connect the dots.
In this episode:
Why Dawn says "You're constipated till proven innocent"
How a full bowel drives daytime wetting and bedwetting
Why kids with chronic constipation "live in the third trimester" (rib position, breathing, and the pelvic floor)
How to teach a child "muscle on, muscle off" with balloons, biofeedback, and a cocktail straw
Toilet training tips for neurodivergent kids
Why "leak" works better than "accident"
What to say if you treat adults and feel nervous about kids
Want to learn more? Dawn teaches Pediatrics Level 1, Treatment of Bowel and Bladder Disorders, with Herman & Wallace. https://hermanwallace.com/continuing-education-courses/pediatrics-level-1-treatment-of-bowel-and-bladder-disorders
You can read more about Dawn and her work here: https://hermanwallace.com/faculty/dawn-sandalcidi
New to pelvic health? This guide walks through how to become a pelvic floor therapist, step by step: https://hermanwallace.com/how-to-become-a-pelvic-floor-therapist
This content is not a substitute for medical care. Views expressed are not necessarily those of Herman & Wallace.